MedicalHistory, 1977,21:182-186.

Texts and Documents

AN EIGHTEENTH-CENTURY BILL OF HEALTHOF THE ORDER OF ST. JOHN FROM MALTA

by

PAUL CASSAR*

DURING iTS two hundred and sixty-eight years of domination over the MalteseIslands (1530-1798), the Order of St. John of Jerusalem waged an unceasing waragainst the Barbary and Turkish pirates in the Mediterranean. Those who escapeddeath were enslaved by the victor, irrespective of sex or age, or whether they werecombatants or simply passengers and crews of unarmed vessels; so much so thatslavery came to form a sort of institution regulated by definite rules concerning theselling, employment and ransoming of captives by either side.A Maltese boy, Gio Maria Zammit, was captured by the Barbary corsairs in 1734

at the age of fifteen years and sold as a slave at Tripoli in North Africa. After twelveyears in captivity he renounced the Catholic faith and turned Moslem, as he wasconstrained to do by his master. He subsequently married a Moslem girl by whom hehad several children. He finally succeeded in escaping from Tripoli after forty-threeyears in captivity, and reached Rome with his fourteen-year-old son Joseph. GioMaria Zammit, by this time sixty-five years old, abjured the Moslem religion, becamereconciled with the Catholic faith and had his son baptised in Rome. He eventuallycame with his son to Malta but being unable to find work, he decided to return toRome in search of employment.

In those days no one could leave Malta without the express permission of theGrand Court of the Castellania. Zammit therefore applied to the Grand Court andobtained the necessary "bill of departure" [patente di partenza] which entitled himto sail from Malta for Sicily, whence he planned to travel to Rome.

Meanwhile, however, he was having trouble with his son. Joseph was getting outof hand and even robbed his father of his little store of money. Out of revenge afterparental punishment, Joseph denounced his father to the Tribunal of the Inquisition.He alleged that his father's real intention in going to Sicily was to board a shipbound for Tripoli, there to rejoin his Moslem wife and children. As the Tribunalwas informed of Gio Maria Zammit's past apostacy, immediate steps were taken toprevent him from leaving the island. He was arrested by the Chief Executive PoliceOfficer [Gran Visconte] and his bill of health was seized and exhibited in court. Whenbrought before the Tribunal, Zammit denied his son's accusation and succeeded inconvincing the judges that it was a trumped-up charge, that he had no intention ofreturning to Tripoli, and that he genuinely meant to seek employment in Rome.The Tribunal released him, but the bill of health was not returned to him and to thisPaul Cassar, M.D., D.P.M., F.R.Hist.S., St. Luke, Pope Alexander VII Junction, Balzan, Malta.

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day it has remained tucked away in the archives of the Tribunal of the Inquisition inMalta.'

DESCRIPTION OF THE DOCUMENTThis bill of health (see Figure 1) is an attractive copper engraving of fine workman-

ship. It occupies a sheet measuring 43 cm by 59 cm and bears a watermark GB inthe right lower corner. The design consists of an architectonic head-piece topped bythe crowned and winged coat-of-arms of Grand Master Emanuel de Rohan Polduc-i.e. nine golden lozenges on a red field quartered with the white cross of the Orderof St. John on a crimson background.The coat-of-arms is flanked on each side by banners and lances and by an allegorical

reclining female figure symbolizing Justice and Prosperity. External to these figures,on a plinth, are the upright effigies of St. John the Baptist on the left and of St. Paulon the right. St. Paul had introduced Christianity to Malta in A.D. 60 and was invokedas protector of the Maltese Islands against all kinds of calamities; St. John was thepatron saint of the Order of St. John of Jerusalem which settled in Malta in 1530.Below the coat-of-arms, in the centre, there is a vignette with an outline map of

the Grand Harbour and of the Port of Marsamxett with their fortifications. The Portof Marsamxett was the quarantine harbour for all shipping reaching the island frominfected areas and had a Lazzaretto on Manoel Island, which is also shown in themap. Small black squares along the shores mark the presence of small towers whereguards were stationed to watch over the coastal areas and prevent illicit entry ofvessels and clandestine disembarkation of passengers and crews in the island's manyinlets.The rest of the decorative design is made up of a floral and leafy border entwined

by a ribbon tied in a loose knot at the bottom. Below this knot is an embossedarmorial paper seal affixed to the sheet with a red wax. It bears the coat-of-arms ofthe castellano, the Knight Antonio Barone de Neveu, who had issued the bill ofhealth. It shows, in its upper third, the white cross of the Order of St. John over ared field and below it two crossed anchors upside down.Within the border is a Latin text, clearly printed in neat lettering in italics. In a

blank space in the print is inserted a handwritten script in Italian recording the namesand other personal details of the passengers and their destination.The designer of the bill was Francesco Manno and the engraver, Garofalo of

Palermo." Their names appear on the plinths beneath the effigies of St. John theBaptist and St. Paul respectively. On the verso of the sheet, handwritten in ink, arethe words: "With shipmaster Marcello Grech" [Con Pad. Marcello Grech].

Cathedral Archives, Mdina. AIM 133c, Processo 384, fol. 1174.'Francesco Manno (1754-1831) was a Sicilian painter and architect and secretary of the Academy

of St. Luke of Rome. He was the brother of Antonio and Vincenzo who, in 1794, painted in frescothe ceiling of the Cathedral of Mdina. C. Siracusano, 'Profilo di Francesco Manno', Quadernidell'Istituto di Storia dell'Arte Medievale e Moderna, Facolta di Lettere e Filosofia, Universita diMessina, Rome, 1975, p. 45; E. Benezit, Dictionnaire des peintres, sculpteurs, dessinateurs et graveurs,Saints Ouen, 1961, vol. 5, p. 753.

Garofalo of Palermo was probably Giuseppe Garofalo who was active in Rome at the time. Ibid.,vol. 4, p. 164.

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The Latin text is as follows:Nos Castellanus sive Praeses Magnae Curiae Castellaniae Melivetanae Universis et singulispraesentes nostras litteras visuris lecturis pariter, et audituris, Salutem Fidem facimus, etverbo veritatis attestamur hanc Inclytam Melitae Insulam, a qua, ejusque generali portu GioMaria Zammit d'anni 65, Giuseppe Zammit d'anni 14 maltesi d'orda. sta. pelo capo e facciabruna partono colla sp. ra di Pad. ne Marcello Grech maltese discedit, Divina favente Clementia,ituri alla Trizza e tutto il Regno di Sicifla nulo, Omnipotentis Dei, ac SS. Joannis Baptistae,et Pauli Protectorum gratia, Epidemicae, seu Pestis morbo laborare; nec in ea hujus morbisuspicionem aliquam adesse. In quorum fidem hasce manu propria firmatas, nostroque sigillomunitas, et manu Magnifici Notarii Magnae Curiae praedictae subscriptas fieri jussimus.Datum in aedibus dictae Magnae Curiae. Die vigesimo secundo Mensis Maii anno millesimoseptincentesimo octuagesimo secundo sive 1782.II Cav.re Neveu Castellano M.Not.Emmanuel Zarb MCC Mel.We, Castellano and President of the Grand Court of the Castellania of Malta, to one and allwho see, read or listen to these our present letters wish good health. We bear witness andtruthfully declare that the renowned Island of Malta is free from epidemic and pestilentialdiseases and of any suspicion thereof through the grace of Almighty God and of the SaintsProtectors John the Baptist and Paul.Gio Maria Zammit, 65 years, and Joseph Zammit, 14 years, both Maltese, of ordinary staturewith dark hair, head and face are departng from the General Harbour with the favour ofDivine Clemency on the speronara [small sailing boat] of Master Marcello Grech for Trizzaand the whole of the Kingdom of Sicily.In assurance ofwhich we have commanded this document, signed by our own hand and furnishedwith our seal, to be subscribed by the Magnificus Notary of the aforesaid Grand Court. Givenat the seat of the said Grand Court this 22nd day of the month of May 1782.The Knight de Neveu Castellano. Magnificus NotaryEmanuel Zarb, The Grand Court of the Castellania of Malta.

COMMENTThe main interest of this bill of health lies in its rarity, for though we meet with

frequent references to the "bulletin of health" [bollettino di salute] in the records ofthe sanitary authorities of Malta during the time of the Order of St. John, this is theonly one that has been encountered by the writer during twenty three years of re-search in Maltese medical history. Its conservation is due to a combination of circum-stances-the state's concern about the public health of Malta on which dependedthe uninterrupted maintenance of commercial relations with neighbouring Medi-terranean ports; the church's jurisdictional powers over the religious beliefs of thepeople of Malta exercised by the Tribunal of the Inquisition; and the care with whichdocumentary evidence against the accused was collected and preserved in his file bythis Tribunal.

It has been stated that the bill of health was introduced in Europe in 1600 whenships' captains were required to produce these documents on entering their nextports of call.3 However "safe conduct certificates" [salviconductus] issued by theGrand Master of the Order of St. John show that the practice was in existence inMalta by 1576, if not earlier. Thus a manuscript copy of one of these certificates,dated 28 May 1576, informs the sanitary authorities of the next port of call that thebearer was entitled to full freedom of movement as "by the grace of God, here (inMalta) we enjoy good health without any suspicion of bad influence [mala influenza]".Another certificate of 27 July 1576 adds "that there was no suspicion of plague".4

' World Health, January-February 1965, p. 31.'Malta Public Library, Valletta (MPL), Arch. 436, fols. 298-307 and 313t.

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Figure 1.A bill of health issued in 1782 by the Order of St. John from Malta. The paper seal at the bottomis not clearly visible, as it is of the same whiteness as the sheet. (Reproduced by courtesy of the

Cathedral Museum Committee, Mdina, Malta.)

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This specific allusion to plague stems from the fact that this disease was endemic inthe Mediterranean and at times assumed epidemic proportions. Indeed the Maltesecode of laws of 1640 laid down detailed rules for the sanitary port authorities toprevent the introduction of "contagious diseases" especially by ships coming fromthe Levant and the coast of Barbary.5 Identical provisions were contained in therevised code promulgated in 1681. These precautions had been dictated by the bitterexperience of two major epidemics of plague that visited the island in 1592 and1675.7 Fears of another outbreak of pestilence were entertained in April 1743 whenplague broke out in Messina, with which port Malta was in constant sea communica-tion but the island escaped infection.8Among the supposed causes of plague, the "wrath of God" was assigned an

important role; hence the attribution, in the bill of health, to freedom from pesti-lence to "the grace of Almighty God and the Saints protectors John the Baptistand Paul". This concept still prevailed many years after the Order of St. John hadbeen driven away from Malta and the British Crown had taken over the island;so much so that the British Governor, Sir Thomas Maitland, ordered the dedicationof a day of "prayer and thanksgiving to Almighty God" on the cessation of theplague epidemic of 1813-14.'

In the eighteenth century the Order of St. John in Malta issued three types ofdocuments to persons departing from the island-a passport, a safe conduct certi-ficate10 and the bill of health. The period of validity of the first two documents variedfrom one to three years but that of the bill of health was very short as it covered onlythe period from the day the passenger left Malta to the time of arrival at the destina-tion specified in the bill. It was of no further use once it was inspected by the sanitaryauthorities of the receiving port and once the traveller was allowed unfettered move-ment on disembarkation.The official authorized to issue the bill of health was the holder of the highest post

in the legal hierarchy in Malta, viz., the Castellano or President of the Grand Courtwhose overall function was to ensure that "justice was rightly administered foreveryone". He was a knight of the Order of St. John and was appointed to, or con-firmed in, office annually by the Grand Master. At the time this bill of health wasdrawn up-1782-the Castellano was Antonio Barone de Neveu of the Langue ofGermany"1 whose armorial bearings can still be seen emblazoned in a frieze on oneof the walls of the old building of the Castellania which is now the seat of the Ministryof Health in Valletta.

In the Maltese legal codes of 1640 and 1681, there is reference to the "bulletin ofthe Court of the Castellania" and to "the usual bulletin" but there is no indicationas to its contents; but the code of laws of 1724, besides alluding to it as "the patent

'MPL. Ms. 148, fol. 70t.MPL. Ms. 150, fol. 153.

7 P. Cassar, Medical history of Malta, London, Wellcome Historical Medical Library, 1965,pp. 165 and 172.

8 P. Cassar, 'Sanitary organization in Malta in 1743', St. Luke's Hosp. Gaz., 1966, 1: 55-59.9 Cassar, op. cit., note 7 above, p. 423.10 MPL. Arch. 586, fols. 238 and 243t.' MPL. Arch. 587, fol. 281.

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or bulletin of departure", specifies it also as "the bill of health".12 Incoming pas-sengers and crews who failed to produce a bill of health from their port ofprovenanceincurred the death penalty if they happened to arrive from ports infected with plagueor suspected of harbouring this disease.There were two kinds of bills-the 'clean" [patente netta] and the "foul" one

[patente brutta].11 The bill here illustrated is a "clean" one. It belongs to the lastyears of the domination of the Order of St. John in Malta since Grand MasterEmanuel de Rohan Polduc was the penultimate Grand Master to rule over theisland before the Knights of St. John were expelled by Napoleon in 1798. As thedocument bears the personal coat-of-arms of this Grand Master, it must have beenin use for a period of not more than twenty-two years covering the period of hisrule from 1775 to 1797.

SUMMARYDuring the rule of the Order of St. John over the Maltese Islands (1530-1798)

no-one could leave the country without first obtaining a bill of health from thePresident of the Maltese Grand Court for submission to the sanitary authorities ofthe next port of call in order to enable them to apply the necessary quarantinemeasures.The bill here described and illustrated was issued in 1782 and consists in an artistic

copper engraving with Latin and Italian wording to the effect that Malta was freefrom epidemic and pestilential diseases. It is decorated with the coat-of-arms of GrandMaster Emanuel de Rohan Polduc, and with the effigies of the "saints protectorsJohn the Baptist and Paul".The main interest of this bill lies in its rarity as it is the only one that has been

encountered during many years of research in Maltese medical history. Althoughit belongs to the last years of the Order's domination of Malta, there is documentaryevidence that the practice of issuing certificates about the state of the public healthof the island for the use of travellers goes back to at least 1576.

ACKNOWLEDGEMENTSI wish to thank the Cathedral Museum Committee, Mdina, for allowing me to study and publish

this docunent and the Rev. John Azzopardi B.D., Lic.D., the curator, for his courtesy and personalinterest in my investigations.

12 MPL., op. cit., note 5 above, fol. 72 and note 6 above fol. 144; Leggi e costituzioni prammaticali,Malta, 1724, pp. 1, 2, 33, 76 and 111.

" Del dritto municipak di Malta, Malta, 1784, pp. 276-7, and 289.

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